SHANDONG UNIVERSITY Liu Zhiyu The Bones of Limbs SHANDONG UNIVERSITY Liu Zhiyu

Bones of upper limb Composition: Should girdle Clavicle Scapula Bones of free upper limb Arm: humerus Forearm Radius Ulna Bones of hand Carpal bones Metacarpal bones Phalanges of fingers

Clavicle “S” shaped, medial 2/3 convex forward and lateral 1/3 convex backward Sternal end medially and acromial end laterally

Scapula Three borders Three angles Two surfaces Superior: coracoid process scapular notch Lateral (axillary) border Medial (vertebral) border Three angles Superior: opposite to the 2nd rib Inferior: opposite to the 7th rib or 7th intercostals space Lateral: glenoid cavity supra- and infraglenoid tubercles Two surfaces Anterior surface concave: subscapular fossa Posterior surface: spine of scapula acromion supra- and infraspinous fossae

Humerus Upper end: Head of humerus Anatomical neck Greater tubercle Lesser tubercle Crest of greater tubercle Crest of lesser tubercle Intertubercular groove Surgical neck

Shaft: Humerus Deltoid tuberosity (on lateral surface) Groove for radial nerve (on posterior surface)

Humerus Lower end: Lateral epicondyle Medial epicondyle Capitulum Trochlea Coranoid fossa (anteriorly) Radial fossa (anteriorly) Olecranon fossa (posteriorly) Sulcus for ulnar nerve

Radius Upper end: Shaft： Lower end: head of radius neck of radius radial tuberosity articular circumference Shaft： interosseous border Lower end: styloid process (laterally) ulnar notch (medially) carpal articular surface (inferiorly)

Ulnar Upper end: Lower end Olecranon coronoid process trochlear notch radial notch ulnar tubersity Lower end styloid process head of ulna

Anteroposterior radiograph of the forearm of a girl aged 11

Colles’ fracture Normally, the radial styloid process projects further distally than the ulnar styloid process. Consequently, when fracture within the distal 2 cm of the radius (Colles’ fracture) occurs, this relationship is reversed because of shortening of the radius.

Carpal bones Proximal row ― (lateral to medial) Scaphoid Lunate Triquetral Pisiform Distal row ― (lateral to medial) Trapezium Trapezoid Capitate Hamate

Carpal bones Td. Tm. C. H. Tq. S. L. P. scaphoid, lunate, triquetral and pisiform trapezium, trapezoid, capitate and hamate

Metacarpal bones Structure of each Numbered one to five from thumb to little finger Structure of each base (proximally) Shaft head (distally)

Phalanges of fingers Consist of 14 ―two for first digit (thumb) and three for each of other four digits Structure of each base (proximally) Shaft trochlea of phalanx (distally) tuberosity of distal phalanx

Bones of Lower Limb Composition: Pelvic girdle: hip bone Bones of free lower limb: Thigh Femur Patella Leg Tibia Fibula Foot Tarsal bones Metatarsal bones Phalanges of toes

Hip bone Consisting of three fused bones Acetabulum Ilium Ischium Pubis Acetabulum Formed by bodies of ilium, ischium and pubis Lunate surface Acetabular fossa Acetabular notch

Ilium Body of ilium Ala of ilium Iliac crest Anterior superior iliac spine Anterior inferior iliac spine Tubercle of iliac crest Posterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Gluteal surface Iliac fossa Arcuate line Auricular surface Iliac tuberosity

An imaginary line joining the highest point on the iliac crests over the fourth lumbar spine.

Ischium Body of ischium Ischial spine Lesser sciatic notch Ramus of ischium ischial tuberosity

Pubis Body of pubis Superior ramus of pubis Inferior ramus of pubis Iliopubic eminence Superior ramus of pubis pecten of pubis pubic tubercle pubic crest symphysial surface Inferior ramus of pubis Obturator foramen

Femur Upper end Femoral head Fovea of femoral head Neck of femur Greater trochanter Lesser trochanter Intertrochanteric line Intertrochanteric crest

Fracture of the femoral neck

Femur Shaft: Linea aspera Gluteal tuberosity Pectineal line Popliteal surface

Femur Lower end: Medial condyle Lateral condyle Medial epicondyle Lateral epicondyle Adductor tubercle Intercondylar fossa Patellar surface

Tibia Upper end: Shaft Lower end: Medial and lateral condyles Intercondylar eminence fibular articular surface tuberosity of tibia Shaft Interosseous border Soleal line Lower end: Fibular notch Medial malleolus

Fibula Upper end: Shaft: Lower end: fibular head neck of fibula interosseous border Lower end: lateral malleolus

Patella triangular sesamoid bone

Tarsal bones Posterior row Intermediate row Anterior row talus Consist of seven short bones arranged in three row Posterior row talus calcaneus Intermediate row navicular bone Anterior row Medial cuneiform Intermediate cuneiform lateral cuneiform cuboid bone

Metatarsal bones Consist of five elongated bones, numbered one to five medial to lateral Structure of each ―base (proximally), shaft, and head (distally) in each

Phalanges of toes ※Surface landmarks: Consist of 14―two for first toe (hallux) and three for each of other four toes ※Surface landmarks: trochlea of talus calcaneal tuberosity tuberosity of navicular bone tuberosity of fifth metatarsal bone